2011-05-13T11:13:04-05:00 2010-06-30 KPMG LLP TWO CENTRAL PARK PLAZA SUITE 1501 OMAHA NE 681021626 990 2009-07-01 470376615 ALEGENT HEALTH-IMMANUEL MEDICAL CENTER ALEG 4023434323 6901 NORTH 72ND STREET OMAHA NE 681221799 Scott M Wooten 4023434315 2011-05-13 1 Heidi Kriete 4023481450 2009 2016-02-24 21:20:13Z SCOTT M WOOTEN 12809 WEST DODGE OMAHA NE 68154 281227679 0 X WWW.ALEGENT.COM X 1904 NE TO PROVIDE HIGH QUALITY CARE FOR THE BODY, MIND AND SPIRIT OF EVERY PERSON. 11 8 2113 402 279117 103315 1988967 696247 270208224 243544887 -6005991 12933425 6211478 22688240 272402678 279862799 20718573 17167842 0 130571897 123464854 0 75327 105002022 129299651 256292492 269932347 16110186 9930452 434719975 511697918 66898198 122419898 367821777 389278020 Faithful to the healing ministry of Jesus Christ, our Mission is to provide high quality care for the body, mind and spirit of every person. Our commitment to healing calls us to:Create caring and compassionate environments Respect the dignity of every person Care for the resources entrusted to us as responsible stewards Collaborate with others to improve the health of our communities Attend especially to the needs of those who are poor and disadvantaged Act with integrity in all endeavors To achieve this Mission, we pledge to be creative, visionary leaders committed to holistic healthcare in the region. 0 0 23387994 1826503 68387658 Alegent Health Immanuel Medical Center Mental Health physicians are unique in their care-giving approach to emotional and behavioral problems of children, adolescents, adults and seniors. Physicians provide the most appropriate care at the level of service that each patient needs. Outpatient and inpatient behavioral service programs are provided. Recently, Immanuel Medical Center built a Residential Treatment Center. This new state of the art facility features 20 private rooms for boys and girls between the ages of six and eighteen years of age. 16257017 1269604 36600421 Alegent Health-Immanuel Medical Center Rehabilitation Center provides comprehensive inpatient and outpatient programs for individuals of all ages. The Rehabilitation Center is the region's most comprehensive center for physical medicine and rehabilitation, offering patients some of the most advanced rehabilitative technology. Immanuel Rehabilitation Center has received the highest level of accreditation awarded by the Joint Commission and by the Commission on Accreditation of Rehabilitation Facilities (CARF). At every level of care, a team of licensed and certified rehabilitation professionals are available. Each one of the rehabilitation programs are designed to maximize independence and quality of life. 5006337 390974 11770466 Alegent Health-Immanuel Medical Center Cancer Support Team is comprised of a group of healthcare professionals who work together in a variety of ways to help the patient and family cope with cancer. Each one of the physicians are equipped to diagnose and aggressively treat cancer and get patients back to there life as soon as possible. Individual team members include Cancer Support Service Specialists, Medical Social Workers, Cancer Rehabilitation Specialists, Pastoral Services, Dietitians, Oncology Nurse Navigators, Hospice & Home Care Services, Inpatient Nursing Services, Radiation Oncology, and Volunteer Services. 176719240 13680761 124414902 ALEGENT HEALTH-IMMANUEL MEDICAL CENTER PROVIDES ADDITIONAL SERVICES INCLUDING BUT NOT LIMITED TO: WEIGHT MANAGEMENT, A 24 HOUR EMERGENCY DEPARTMENT, INPATIENT HOSPITAL FACILITIES, PROCEDURE CENTER, ORTHOPEDIC SERVICES, DIGESTIVE HEALTH CENTER, FAMILY LIFE CENTER, RADIOLOGY, UROLOGY, DIAGNOSTIC SERVICES AND PHYSICAL THERAPY. PATIENTS ARE AT THE CENTER OF ALL SERVICES PROVIDED AT ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. 176719240 13680761 124414902 221370588 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 156 0 1 2113 1 1 1 0 0 0 0 1 1 0 0 0 11 8 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X SCOTT M WOOTEN SENIOR VPCFO 4023434323 12809 W DODGE ROAD OMAHA NE 68154 LESLIE R ANDERSEN 6.00 X X 0 0 0 SR LILLIAN MURPHY RSM 4.00 X 0 0 0 ANTHONY HATCHER DO 6.00 X X 0 498263 35568 JOHN HEWITT 6.00 X X 0 0 0 MARTIN MANCUSO MD 4.00 X 0 16000 0 SUSAN PEACH RN 4.00 X 0 0 0 Rick Vierk 4.00 X 0 23500 0 MICHAEL DEFREECE 4.00 X 0 0 0 PAUL EDGETT III 4.00 X 0 0 0 ERIC GURLEY 4.00 X 0 276770 18834 KEITH SCHMODE 4.00 X 0 5000 0 GUILLERMO HUERTA MD 4.00 X 0 0 0 WAYNE A SENSOR 15.00 X 453281 1303553 23329 RICHARD HACHTEN II 15.00 X 422333 1214557 734490 FRED HOSLER MD 15.00 X 241098 693354 369747 MARTIN HICKEY MD 15.00 X 210570 605560 45701 KENNETH LAWONN 15.00 X 166880 479917 38536 SCOTT WOOTEN 15.00 X 196559 565268 20275 MARK KESTNER MD 15.00 X 135626 390035 158309 JOAN NEUHAUS 15.00 X 119803 344531 185399 MARGARET BREEN 15.00 X 121855 350431 17268 AMY PROTEXTER 15.00 X 105687 303934 28487 PATRICIA NADLE 15.00 X 34112 98100 252625 PAUL EBMEIER 15.00 X 85577 246106 22704 SHEREE KEELY 15.00 X 56567 162676 21999 Elizabeth LLEWELLYN 15.00 X 69043 198557 21048 PATRICIA MASEK 15.00 X 56367 162103 43278 FRANK EMSICK 15.00 X 68910 198172 24435 ANN SCHUMACHER 15.00 X 112315 323000 34147 JAYNE MCCORMICK MD 60.00 X 0 232062 16991 Arun Sharma MD 60.00 X 409976 0 44114 Michael L Egger MD 60.00 X 284448 0 41134 Thomas A Franco MD 60.00 X 414263 0 38725 Michael L Coy MD 60.00 X 331629 0 28426 Hudson H T Hsieh MD 60.00 X 296043 0 36519 THEODORE SCHWAB 0.00 X 96122 276430 19719 DUANE DAVID 0.00 X 54030 155379 0 JARROD JOHNSON 0.00 X 56729 163140 5703 JOHN MAY 0.00 X 67867 195172 3737 Ann Jones 0.00 X 67476 194053 4177 MICHAEL ANDERSON MD 0.00 X 39693 114149 4835 Pete Festersen 0.00 X 47436 136417 1088 4822295 9926189 2341347 61 1 1 0 Cassling DIAGNOSTIC IMAGING INC 13808 F Street OMAHA NE 68137 DIAGNOSTIC IMAGING SERVICES 1804080 MORRISON MANAGEMENT SPECIALISTS 5801 Peachtree Dunwoody Road ATLANTA GA 30342 FOOD SERVICE 330286 NORTHWEST ANESTHESIA PC 6901 N 72nd Street OMAHA NE 68122 Anesthesia Services 306944 SENTRY DATA SYSTEMS INC 600 Fairway Drive Suite 201 DEERFIELD FL 33441 PHARMACY MANAGEMENT TECHOLOGY 284635 HORIZON HEALTH CORPORATION 2941 Lake Vista Drive LEWISVILLE TX 75067 BEHAVIORAL HEALTH SERVICES 270579 24 66800 10800 585314 33333 696247 NET PATIENT SVC REVENU 621500 235391030 235391030 REIMBURSABLE-AFFILIATE 621990 5286591 5286591 HOSPITAL PHARMACY 446110 1710966 1710966 FOOD & NUTRITION 722320 660474 50877 609597 JOINT HEALTH VENTURES 900099 406981 406981 88845 88845 243544887 67413 67413 1141583 710454 431129 431129 431129 12867549 361672 363209 12867549 -1537 12866012 12866012 178520 10800 83486 95034 95034 410061 207731 202330 202330 JOA Settlements 812300 16837000 16837000 REIMBURSED SERVICES 621990 2391122 2391122 MISCELLANEOUS OPERATIN 561499 1855686 228240 1627446 875939 875939 21959747 279862799 241173447 279117 37713988 23475 23475 17144367 17144367 3157875 2684194 473681 94257145 76568615 17618780 69750 3797734 3343977 453757 16897055 10670571 6225095 1389 5355045 5083482 267375 4188 19807 1214 18593 18276 18276 12115508 8005507 4110001 19488 19488 44632306 44053528 578778 5798380 5798380 159711 92321 67390 69436 69436 3449418 3449418 17744845 12977771 4767074 488481 488481 PURCHASED SERVICES 13079344 5271769 7807575 BAD DEBTS 12152430 12152430 EQUITY NET LOSS 9303365 9303365 MANAGEMENT ALLOCATIONS 6483664 385331 6098333 MISCELLANEOUS 3416974 3416974 348218 348218 269932347 221370588 48486432 75327 925120 414057 32007913 20155527 24160833 25509809 3797460 4008795 119776 230776 307408035 162394438 114180470 145013597 197237127 280079981 1921074 33661805 20583830 26708397 15701546 434719975 511697918 9717791 8555178 7539 7539 56878805 111165217 294063 2691964 66898198 122419898 X 364379654 385378337 1652123 2109683 1790000 1790000 367821777 389278020 434719975 511697918 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 X 18276 262701 18276 262701 269914071 530861023 269932347 531123724 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 124534 136554 176941 262701 700730 250000 250000 250000 250000 1000000 1500000 2665977 126695 298938 9996 142744 2938870 2688014 800115 -448721 3875 369556 2665977 0.46000 0.54000 0 1 1 1726657 1726657 131376349 66526361 64849988 479327 288113 191214 145717562 95579964 50137598 28108140 28108140 145013597 3RD PARTY PAYER SETTLEMENTS 2690297 Other Liabilities 1667 2691964 Part V, Line 4: Description of Intended Use of Endowment Funds: ENDOWMENT FUNDS ARE INTENDED TO HELP WITH THE ORGANIZATIONAL OPERATIONS OF ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. PART X - THE ENTITIES REPORTED IN THE CONSOLIDATED AUDIT HAVE ADOPTED FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, INCLUDED IN FASB ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL, ENTITIES OF ALEGENT HEALTH RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. DURING 2010 AND 2009, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. Immanuel Women's Imaging Center 189320 10800 178520 2500 11700 69286 189320 10800 178520 2500 11700 69286 83486 95034 1 1 X 0 0 1 1 0 1 1 7567 9280503 12722 9267781 0.03600 2348 43450355 28031946 15418409 0.05980 9915 52730858 28044668 24686190 0.09580 12965 245982 28338 217644 0.00080 281 474925 182159 292766 0.00110 9651066 9187569 463497 0.00180 511237 108468 402769 0.00160 40 259826 259826 0.00100 13286 11143036 9506534 1636502 0.00630 23201 63873894 37551202 26322692 0.10210 2 92361 8784 83577 0.00030 14 163167 1853 161314 0.00060 4 330 330 0.00000 20 255858 10637 245221 0.00090 1 5671785 1646584 49332174 64952195 -15620021 X 1 1 ALEGENT HEALTH IMMANUEL MEDICAL CENTER

6901 North 72nd Street OMAHA NE 68122

X X X AH IMMANUEL FONTENELLE HOME

6809 NORTH 68TH PLAZA OMAHA NE 68152

SKILLED NURSING FACILITY Part I, Line 3c: Alegent Health-Immanuel Medical Center is part of the Alegent Health System. The amount of financial assistance write-off for entities of the Alegent Health System IS based on a financial assistance sliding fee schedule utilizing a derivative of the current US Dept of Housing and Urban Development (HUD) very low income guidelines, which are updated yearly.ALL EFFORTS ARE MADE TO ESTABLISH WHETHER PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE PRIOR TO SERVICE IF POSSIBLE, OTHERWISE AS SOON AS POSSIBLE FOLLOWING SERVICE. REPRESENTATIVES OF THE ALEGENT HEALTH SYSTEM HELP PATIENTS SEEK REIMBURSEMENT FROM LOCAL, STATE AND FEDERAL PROGRAMS AT NO CHARGE TO THE PATIENT. AFTER THESE EFFORTS AND RESOURCES HAVE BEEN EXHAUSTED, PATIENTS ARE ASSISTED IN THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCE CONSISTENT WITH ALEGENT HEALTH'S FINANCIAL ASSISTANCE POLICY.THE APPLICATION PROCESS REQUIRES THAT THE PATIENT COMPLETE A PERSONALFINANCIAL APPLICATION AND PROVIDE VERIFICATION DOCUMENTS. VERIFICATIONINCLUDES EMPLOYMENT VERIFICATION AND OBTAINING DOCUMENTATION OF THE APPLICANT'S FINANCIAL CONDITION SUCH AS FEDERAL TAX RETURN, PAY STUB, NET WORTH AND/OR LIQUID ASSETS AND REASONABLE HOUSEHOLD OR BUSINESS EXPENSES. FINANCIAL ASSISTANCE MAY STILL BE GRANTED IN CERTAIN CIRCUMSTANCES INVOLVING A CATASTROPHIC OCCURRENCE RESULTING IN MEDICAL BILLS GROSSLY EXCEEDING THE PATIENT'S ABILITY TO PAY, AND IN THESE SITUATIONS, THE PATIENT'S RESPONSIBILITY WILL BE LIMITED TO 20% OF THE FAMILY'S GROSS ANNUAL INCOME.Part I, line 6a: The Alegent Health System produces a public community benefit report that is mailed to a core constituency and placed in key places throughout the organization. It is also available on the COMPANY'S intranet site, and on its public website at www.alegent.com. Part I, Line 7: THE COSTING METHOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WERE WORKSHEETS 1 - 8 PROVIDED WITH THE SCHEDULE H INSTRUCTIONS. THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE TOTAL COMMUNITY BENEFIT EXPENSE FOR CHARITY CARE, MEDICAID AND OTHER MEANS TESTED. Part I, Line 7g: Alegent Health Immanuel Medical Center provides subsidized health to the broader community via behavioral health services. Part I, Line 7f: Bad debt of $12,152,430 included in THE functional expense total part IX, line 25 is not included in the total operating expense used to calculate the table 7 percentages. Part III, Line 4: THE AUDITED FOOTNOTES FOR ENTITIES OF THE ALEGENT HEALTH SYSTEM DO NOT CONTAIN FOOTNOTES RELATED TO BAD DEBT EXPENSE. BAD DEBT EXPENSE IS IDENTIFIED ON THE CONSOLIDATED STATEMENT OF OPERATIONS WHICH IS CONSISTENT WITH THE REPORTING PRACTICE OF OTHER HEALTH CARE ORGANIZATIONS.Bad debt expense (at cost) for Entities of Alegent Health is determined by using the cost to charge ratio from Medicare Cost reports per entity and multiplying the ratio by the actual bad debt charges per entity.To determine the amount of the ORGANIZATION'S bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy, Representatives of the Alegent Health System determine if an account needs to be moved from bad debt to charity when a patient either comes forward and completes a charity application, which is approved or if it is determined that the patient has no other resources to pay the account balance. Part III, Line 8: The Alegent Health System does not consider Medicare shortfalls to be community benefit, per the recommendation of the Catholic Health Association. The Medicare charges reported on line 5 and 6 are from Medicare cost reports which used a cost to charge ratio. Part III, Line 9b: THE Alegent HEALTH'S SELF PAY BILLING AND BAD DEBT POLICY HAS A CLEARLY DELINEATED PROCESS FOR COLLECTION AGENCIES TO FOLLOW, INCLUDING EXPLICIT INSTRUCTIONS THAT ENSURE THE CHARITY CARE PATIENTS WHO HAVE BEEN IDENTIFIED DO NOT GO TO COLLECTIONS.PART V: 1 SKILLED NURSING FACILITY. Part VI, Line 2: THE ALEGENT HEALTH SYSTEM APPROACHES COMMUNITY NEEDS ASSESSMENT AS A CORPORATE ACTIVITY THAT DEVELOPS AND INTEGRATES COUNTY BASED HEALTH PROFILES FOR EACH OF THE COUNTIES WHERE ONE OF THE LICENSED HOSPITALS ARE LOCATED. THE PROCESS TO DEVELOP THE ASSESSMENTS IS COLLABORATIVE IN NATURE AND INVOLVES HEALTH DEPARTMENTS, EXISTING HEALTH COALITIONS, COMMUNITY MEMBERS AND HOSPITAL LEADERSHIP, AND IS SUPPORTED BY THE ALEGENT HEALTH PLANNING AND COMMUNITY BENEFIT DEPARTMENT STAFF. THE ALEGENT HEALTH PLANNING DEPARTMENT CONDUCTS MARKET ASSESSMENTS THAT IDENTIFY THE OMAHA METROPOLITAN STATISTICAL AREA'S POPULATION AND DEMOGRAPHIC CHARACTERISTICS. ADDITIONALLY, IN COOPERATION WITH LOCAL HEALTH DEPARTMENTS AND COALITIONS, THE ALEGENT HEALTH COMMUNITY BENEFIT/HEALTHIER COMMUNITY DEPARTMENT CONDUCTS AN ANNUAL REVIEW OF THE DOCUMENTED COMMUNITY HEALTH NEEDS AND PLANS OF EACH OF THE COMMUNITIES IT SERVES. THIS ASSESSMENT PROCESS INVOLVES SUMMARIZING EXISTING DATA AND RESEARCH FROM LOCAL HEALTH DEPARTMENT REPORTS AND LOCAL COALITION REPORTS INTO A COMPREHENSIVE SUMMARY GRID INCORPORATING A MULTITUDE OF FACTORS INCLUDING- DEMOGRAPHICS, HEALTH STATUS METRICS, Behavioral Risk Factor Surveillance Survey DATA, DOCUMENTED HEALTH ISSUES, QUALITATIVE INFORMATION FROM QUALITATIVE AND COMMUNITY BASED PROCESSES AND IDENTIFICATION OF ALEGENT HEALTH'S PARTICIPATION AND SPECIFIC STRATEGIC ACTION PLANS. THE PROFILES ARE INTEGRATED INTO THE GOVERNANCE AND PLANNINGFOR ALEGENT HEALTH ON TWO LEVELS:I. REPORTING TO THE COMMITTEE OF THE BOARD OF DIRECTORS CHARGED WITHHEALTH PLANNING OVERSIGHTII. INTO THE ANNUAL STRATEGIC PLANNING PROCESSES OF ALEGENT HEALTH.PARTICULAR TO DOUGLAS COUNTY, WHICH IMMMANUEL MEDICAL CENTER RESIDES,NEEDS ASSESSMENT AND REPORTING OF THOSE NEEDS IS LED BY LIVE WELL OMAHA, AMEMBERSHIP BASED COALITION. LIVE WELL OMAHA HAS BEEN IN EXISTENCE FOR 14YEARS AND ALEGENT HEALTH WAS A FOUNDING MEMBER AND IS THE LARGESTFINANCIAL CONTRIBUTOR. Part VI, Line 3: There are several financial assistance access points throughout a PATIENT'S care cycle. Bills contain financial assistance verbiage; signs are posted in clinics and hospital, and there is information on financial assistance posted at registration points throughout clinics and hospitals. Information on THE Alegent Health SYSTEM'S financial assistance policies are located several places on www.alegent.com. Part VI, Line 4: THE ALEGENT HEALTH SYSTEM SERVES THE OMAHA METROPOLITAN STATISTICAL AREA, WITH AN ESTIMATED POPULATION OF 842,976, RANKING 60TH OUT OF 366 MSAS IN THE TOTAL POPULATION. ON AVERAGE, THE POPULATION IS OLDER THAN THE U.S. WITH A CURRENT MEDIAN AGE OF 34.9 YEARS THAT IS PROJECTED TO INCREASE TO 35.5 BY 2014. 50.6% OF THE POPULATION IS FEMALE. THE OMAHA MSA RACIAL AND ETHNIC MAKEUP IS APPROXIMATELY 83.9% WHITE, 7.7% BLACK AND 7.6% HISPANIC OR LATINO.THE 2009 ESTIMATES SHOW THAT THERE ARE APPROXIMATELY 326,989 HOUSEHOLDS, WHICH IS PROJECTED TO INCREASE OVER THE NEXT FIVE YEARS. THE AVERAGEHOUSEHOLD INCOME IS $68,637, WITH A PER CAPITA INCOME OF $26,840 (VSNATIONAL OF $26,410). Part VI, Line 5: AS A RESULT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2006, WHICH POINTED TO CHILDHOOD OBESITY AS A SERIOUS HEALTH NEEDS ISSUE ACROSS ALL OMAHA MSA COUNTIES SERVED, THE ALEGENT HEALTH SYSTEM PARTNERED WITH THE COMMUNITY AND MADE A MULTI-YEAR COMMITMENT TO IMPACT CHILDHOOD OBESITY THROUGH COMMUNITY BASED BEST PRACTICE INTERVENTIONS. THIS INITIATIVE HAS HAD A PRIMARY FOCUS OF IMPACT IN DOUGLAS COUNTY, BUT THE FUNDING TO UNDERWRITE HAS COME FROM THE FISCAL PERFORMANCE OF ALL ALEGENT HEALTH HOSPITALS. THE COMMUNITY COALITION KNOWN AS LIVE WELL OMAHA KIDS (LWOK) IS STAFFED AND FUNDED BY ALEGENT HEALTH. An Executive committee, which consists of community leaders and policy makers, have implemented an ecological approach that improves programs, policies and promotes physical activity and healthy eating habits at the individual and organizational levels. MORE THAN 200 VOLUNTEERS HAVE PARTICIPATED IN THE PLANNING AND IMPLEMENTATION OF LWOK INITIATIVES. A PORTION OF THIS INVESTMENT IN LWOK IS ALLOCATED TO THE ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. Part VI, Line 6: THE PRIMARY CARE PHYSICIAN CLINICS THAT ARE PART OF THE ALEGENT HEALTH SYSTEM PARTICIPATE IN MEDICAL STUDENT PRECEPTORSHIPS THAT ADVANCE THE HEALTHCARE PROVIDER EDUCATION PROCESS. THE ALEGENT HEALTH SYSTEM HAS OPEN MEDICAL STAFFS AND IS ONE OF 3 HEALTH SYSTEMS THAT FUND THE OPERATIONS OF A COALITION THAT EXISTS TO PROVIDE ACCESS FOR THE PATIENTS OF 3 AREA Federally Qualified Community Health CenterS TO SPECIALTY PHYSICIAN SERVICES AND HOSPITAL BASED DIAGNOSTICS AND TREATMENT. THE ALEGENT HEALTH SYSTEM IS THE SOLE COMPREHENSIVE ACUTE MENTAL HEALTH PROVIDER IN THE OMAHA MSA AREA. THE ALEGENT HEALTH SYSTEM IS A JOINT VENTURE PARTNER IN A NOT-FOR-PROFIT HOSPICE INPATIENT HOSPITAL AND PROVIDES THE MANAGEMENT SUPPORT CONTRACT. THE ALEGENT HEALTH SYSTEM BUDGETS FOR AN EMERGENCY FUND AS A SUBSET OF OTHER COMMUNITY DONATIONS TO RESPOND TO CRISIS OR UNPLANNED FUNDING NEEDS OF A VITAL COMMUNITY SERVICE, WHICH WAS FIRST USED IN FY2010 WITH THE ECONOMIC DOWNTURN. THE ALEGENT HEALTH SYSTEM HAS A CURRENT COMMITMENT TO SET ASIDE UP TO 6% OF ITS EBIDA IN A GIVEN FISCAL YEAR FOR COLLABORATIVE INITIATIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES SERVED, WHICH IS THE CATALYST FUND.BOARD OF DIRECTORS - THE ALEGENT HEALTH SYSTEM is governed by a Board of Directors primarily comprised of volunteer members of our local community who are leaders in the fields of business, healthcare, accounting and medicine and understand their role in providing strong corporate governance. The Board of Directors consists of twelve voting members and two non-voting members. EMERGENCY DEPARTMENT - ALEGENT HEALTH IMMANUEL MEDICAL CENTER hospital has a full-time emergency department that is open to the public and provides medical screening examinations and stabilizing treatment within the capabilities and capacity of the hospital regardless of but not limited to the PATIENT'S race, color, sex, age, and/or ability to pay. The hospital is in compliance with the federal EMTALA regulations.In addition, ALEGENT HEALTH IMMANUEL MEDICAL CENTER, together with unrelated hospitals in the area, work closely with local fire and rescue departments to ensure that ambulances take patients to the appropriate hospital. This is generally the hospital that is closet geographically with exceptions based on patient preference, PATIENT'S physician preference, and capacity or the availability of specialized facilities or programs related to the PATIENT'S condition. Finally, ALEGENT HEALTH IMMANUEL MEDICAL CENTER maintains detailed procedures regarding when and under what circumstances a patient can be transferred. Under this policy, no patient will be transferred based on race, creed, religion or ability to pay.MEDICAL STAFF - The hospital maintains an open medical staff. All qualified MDs, DOs, other healthcare practitioners, and mid-level practitioners are eligible to apply for privileges at the hospital. ALEGENT HEALTH IMMANUEL MEDICAL CENTER'S policy on physician credentialing is that no individual is to be denied medical staff appointment based on sex, race, creed, color or national origin. The standards a physician must meet for appointment relate to (1) educational qualifications and licensing; (2) professional competence, (3) character, (4) ethical standing, and (5) ability to relate to and work with others. Applications are reviewed at several levels within the organization. Physicians who have been granted staff privileges automatically become members of the Medical staff at the hospital. Part VI, Line 7: THE SENIOR LEADERSHIP OF THE INDIVIDUAL HOSPITALS ARE ENGAGED IN THE COMMUNITY NEEDS ASSESSMENT PROCESS THAT IS CONDUCTED FROM THE CORPORATE OFFICES OF THE ALEGENT HEALTH SYSTEM (SEE PART VI-2/COMMUNITY NEEDS ASSESSMENT). THE HOSPITALS ARE INVOLVED IN SHARED BUDGET DECISION MAKING TO MEET THE PRIORITIZED COMMUNITY HEALTH NEEDS IN COLLABORATION WITH COMMUNITY PARTNERS. THE CORPORATE FUNCTION IS FUNDED FROM THE OPERATIONS OF THE INDIVIDUAL HOSPITALS TO LEVERAGE EXPERTISE AND TIME THAT IS FOCUSED ON PROMOTING HEALTH. THE INDIVIDUAL HOSPITALS BECOME MORE INVOLVED IN SPECIFIC STRATEGIC RESPONSES THROUGH THE SERVICES THEY PROVIDE AND THEIR PARTICIPATION IN THE COALITIONS ACROSS THE ALEGENT HEALTH SERVICE AREA. 1 RONCALLI CATHOLIC HIGH SCHOOL 6401 SORENSEN PKWY OMAHA NE 68152 470486481 501(c)(3) 10000 GENERAL SUPPORT 1 SCHOLARSHIPS 18 5550 CHARITY CARE 7567 17138817 BOOK REDUCE OR WRITE OFF OF PATIENT SERVICES Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: MOST DISBURSEMENTS IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PROGRAMS ARE MADE DIRECTLY IN THE ACTIVE CONDUCT OF THE ACTIVITIES CONSTITUTING THE EXEMPT PURPOSE OR FUNCTION OF THE ORGANIZATION. OTHERWISE, DISTRIBUTIONS IN FURTHERANCE OF THE INSTITUTION'S EXEMPT PROGRAMS ARE MADE IN ACCORDANCE WITH PROCEDURES OR SUBJECT TO CONDITIONS ESTABLISHED BY THE INSTITUTION'S GOVERNING BOARD OR MANAGEMENT DESIGNED TO ENSURE THAT RECIPIENTS OF SUCH DISBURSEMENTS FROM THE ORGANIZATION ARE ADEQUATELY INVESTIGATED AND GRANTED TO QUALIFIED RECIPIENTS. THESE FUNDS ARE DIRECTLY USEd TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE. SISTER INGEBORG BLOMBERG SCHOLARSHIP: SCHOLARSHIPs are PROVIDED BY THE IMMANUEL MEDICAL CENTER AUXILIARY TO PROVIDE CONTINUING EDUCATION FOR ALEGENT HEALTH-IMMANUEL MEDICAL CENTER EMPLOYEES FOR THEIR PERSONAL GROWTH AND/OR PROFESSIONAL DEVELOPMENT. ALL PERMANENT, FULL-TIME AND PART-TIME EMPLOYEES IN GOOD STANDING WHO HAVE SIX MONTHS OR MORE OF SERVICE WITH ALEGENT HEALTH-IMMANUEL MEDICAL CENTER MAY APPLY FOR THE SCHOLARSHIPS. PAYMENT FOR TUITION, LAB FEES, BOOKS AND REGISTRATION EXPENSES WILL BE MADE DIRECTLY TO THE INSTITUTION UPON RECEIPT OF A STATEMENT OF COSTS FROM THE INSTITUTION. THE AWARDING OF THE SISTER INGEBORG BLOMBERG SCHOLARSHIP SHALL BE SUBJECT TO THE FOLLOWING CRITERIA: 1. APPLICATION IS MADE PRIOR TO MAKING A COMMITMENT TO THE SCHOOL 2. THE SCHOOL AND COURSE ARE OF RECOGNIZED STANDING 3. THE EMPLOYEE CONTINUES TO MAINTAIN HIS/HER REGULARLY SCHEDULED WORKING HOURS 4. THE EMPLOYEE SHALL SIGN AN AUTHORIZATION ALLOWING THE AUXILIARY TO RECEIVE WRITTEN CERTIFICATION OF PERFORMANCE FROM THE INSTITUTION 5. IT IS EVIDENT THAT THE COURSE, OR COURSES, ARE MUTUALLY BENEFICIAL TO THE EMPLOYEE AND TO ALEGENT HEALTH-IMMANUEL MEDICAL CENTER 6. THE EMPLOYEE IS EXPECTED TO REMAIN EMPLOYED AT ALEGENT HEALTH-IMMANUEL MEDICAL CENTER FOR AT LEAST ONE YEAR AFTER RECEIVING THE SISTER INGEBORG BLOMBERG SCHOLARSHIP. Other Information: Part IV: SCHEDULE I, PART I, LINE 2: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER occassionally DISTRIBUTES FUNDS TO OTHER 501(c)(3) ORGANIZATIONS. THESE DISTRIBUTIONS ARE MONITORED TO ENSURE THEY ARE BEING USED AS SPECIFIED BY THE ORGANIZATION. SCHEDULE I, PART III - Alegent Health-IMMANUEL MEDICAL CENTER recognizes the right to quality healthcare regardless of age, sex, race, religion, national origin, or ability to pay. Business office staff helps patients seek local, state, and federal reimbursement at no charge when no other source of payment is available. Financial assistance is provided to patients with demonstrated inability to pay for medically necessary services. THESE FUNDS ARE DIRECTLY USED TO OFFSET THE PATIENTS ACCOUNTS RECEIVABLE. X 1 1 X X X X X 1 1 0 1 0 1 1 0 0 ANTHONY HATCHER DO 0 361253 0 57454 0 79556 0 19380 0 16188 0 533831 0 0 ERIC GURLEY 0 254034 0 0 0 22736 0 0 0 18834 0 295604 0 0 WAYNE A SENSOR 138774 399090 84962 244334 229545 660129 4368 12562 1651 4748 459300 1320863 212951 612407 RICHARD HACHTEN II 74364 213860 4169 11991 343800 988706 188910 543269 596 1715 611839 1759541 333856 960111 FRED HOSLER MD 95888 275758 46342 133270 98868 284326 93617 269226 1781 5123 336496 967703 85129 244816 MARTIN HICKEY MD 100075 287797 36760 105716 73735 212047 9577 27544 2214 6366 222361 639470 28079 80751 KENNETH LAWONN 73719 212003 34870 100279 58291 167635 8334 23966 1609 4627 176823 508510 53665 154332 SCOTT WOOTEN 96918 278718 43959 126418 55682 160132 3420 9835 1811 5209 201790 580312 49717 142978 MARK KESTNER MD 57945 166640 26434 76019 51247 147376 38383 110384 2462 7080 176471 507499 37680 108362 JOAN NEUHAUS 75655 217569 23142 66554 21006 60408 46866 134777 969 2787 167638 482095 20077 57737 MARGARET BREEN 48581 139710 33079 95129 40195 115592 3793 10908 662 1905 126310 363244 34384 98882 AMY PROTEXTER 36892 106092 31648 91015 37147 106827 5271 15158 2079 5979 113037 325071 28989 83368 PATRICIA NADLE 33133 95284 0 0 979 2816 64150 184483 1030 2962 99292 285545 0 0 PAUL EBMEIER 70190 201857 13022 37449 2365 6800 4368 12562 1490 4284 91435 262952 0 0 SHEREE KEELY 37932 109085 12106 34815 6529 18776 4476 12873 1200 3450 62243 178999 6453 18556 Elizabeth LLEWELLYN 37421 107617 14175 40766 17447 50174 5170 14867 261 750 74474 214174 12816 36856 PATRICIA MASEK 35629 102462 11422 32849 9316 26792 10162 29224 1004 2888 67533 194215 5744 16520 FRANK EMSICK 43201 124236 13991 40236 11718 33700 4394 12636 1911 5494 75215 216302 11429 32867 ANN SCHUMACHER 70211 201917 22716 65326 19388 55757 5953 17118 2858 8218 121126 348336 19007 54661 JAYNE MCCORMICK MD 0 175075 0 0 0 56987 0 16672 0 319 0 249053 0 0 Arun Sharma MD 397597 0 0 0 12379 0 19380 0 24734 0 454090 0 0 0 Michael L Egger MD 260504 0 0 0 23944 0 19380 0 21754 0 325582 0 0 0 Thomas A Franco MD 358507 0 31602 0 24154 0 21830 0 16895 0 452988 0 0 0 Michael L Coy MD 300344 0 0 0 31285 0 19380 0 9046 0 360055 0 0 0 Hudson H T Hsieh MD 267409 0 0 0 28634 0 16930 0 19589 0 332562 0 0 0 THEODORE SCHWAB 0 0 0 0 96122 276430 949 2729 4140 11901 101211 291060 95998 276073 DUANE DAVID 0 0 0 0 54030 155379 0 0 0 0 54030 155379 53908 155029 JARROD JOHNSON 2356 6775 7491 21542 46882 134823 585 1681 887 2550 58201 167371 44895 129109 JOHN MAY 2557 7353 8514 24485 56796 163334 684 1968 281 804 68832 197944 54262 156049 Ann Jones 2082 5992 8620 24790 56774 163271 0 0 1078 3099 68554 197152 55448 159460 MICHAEL ANDERSON MD 2374 6826 8042 23127 29277 84196 1067 3070 180 518 40940 117737 27840 80063 Pete Festersen 2663 7657 6291 18093 38482 110667 0 0 281 807 47717 137224 37863 108886 Part I, Line 1a As part of the executive compensation arrangement, executives are provided with a set sum, approximately 30 - 40% of their base salary, which can be used to elect various benefits. Some of the benefits available for election include health club dues, automobile allowance, financial planning fees and legal fees. Payment for these benefits are either made directly by Alegent Health or reimbursed to the executive after the appropriate substantiation for the expense is provided. The amount paid for these benefits is included in the EXECUTIVE'S wages as taxable income. Part I, Line 4a The following reportable individuals received severance payments from Alegent Health (a related organization) during the 2009 calendar year and these severance payments were included in the INDIVIDUAL'S W-2 income and reportable as compensation on Schedule J: DUANE DAVID - $208,937 THEODORE SCHWAB - $371,912 WAYNE SENSOR - $124,126 RICHARD HACHTEN II - $363,816 FRED HOSLER, MD - $87,750 MARGARET BREEN - $53,962 AMY PROTEXTER - $49,415 ANN JONES - $187,565 MICHAEL ANDERSON - $29,164 JARROD JOHNSON - $162,988 MARK KESTNER, MD - $63,691 JOHN MAY - $185,254 PETE FESTERSEN - $136,893. SCHEDULE J, LINE 4B - ALEGENT HEALTH HAS A MARKET BASED NONQUALIFIED RETIREMENT PLAN APPROVED BY THE BOARD OF DIRECTORS THAT EXECUTIVES PARTICIPATE IN OF WHICH ANNUAL CONTRIBUTIONS ARE MADE. DURING 2009, THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TERMINATED AND PARTICIPANTS RECEIVED A TOTAL PAYOUT OF THEIR BALANCE. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS FROM ALEGENT HEALTH DURING THE 2009 CALENDAR YEAR AND THE PAYMENTS WERE INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE AS COMPENSATION ON SCHEDULE J: RICHARD HACHTEN II - $930,151 FRED HOSLER, MD - $242,195 KENNETH LAWONN - $207,997 MARGARET BREEN - $79,304 MARTIN HICKEY - 108,830 JARROD JOHNSON - $11,015 ANN JONES - $27,343 SHEREE KEELY - $25,009 MARK KESTNER, MD - $82,351 ELIZABETH LLEWELLYN - $49,672 PATRICIA MASEK - $22,264 FRANK EMSICK - $44,295 JOHN MAY - $25,057 JOAN NEUHAUS - $77,813 AMY PROTEXTER - $62,943 SCOTT WOOTEN - $192,696 ANN SCHUMACHER - $73,668 THEODORE SCHWAB - $159 WAYNE SENSOR - $701,232 MICHAEL ANDERSON - $78,739 PETE FESTERSEN - $9,856. Part I, Line 5 PHYSICIANS EMPLOYED BY ALEGENT HEALTH-IMMANUEL MEDICAL CENTER ARE ELIGIBLE FOR QUARTERLY PRODUCTIVITY BONUSES BASED ON INDIVIDUAL QUALITY MANAGEMENT, WHICH INCLUDE CORE MEASURES, PHYSICIAN REFFERAL AND ATTENDANCE AT MEETINGS. THE CORE MEASURES USED TO DETERMINE THE PHYSICIAN BONUSES are NATIONALLY ACCEPTED MEASUREs OF PHYSICIAN PRODUCTIVITY. Part I, Line 6 COMPENSATION FOR MEMBERS OF MANAGEMENT OF ALEGENT HEALTH AND RELATED ENTITIES IS DETERMINED AT A SYSTEM LEVEL. MEMBERS OF ALEGENT HEALTH MANAGEMENT ARE ELIGIBLE FOR AN ANNUAL INCENTIVE BONUS. INCENTIVE AWARDS ARE BASED ON FOUR INDIVIDUAL PERFORMANCE MEASURES WHICH ARE LINKED TO FOUR SYSTEM PERFORMANCE GOALS. FOR EACH MANAGER, 75% OF THE INCENTIVE AWARD WILL BE DETERMINED BY SYSTEM PERFORMANCE GOALS AND 25% DETERMINED BY INDIVIDUAL PERFORMANCE. ONE OF THE FOUR SYSTEM PERFORMANCE GOALS IS DEPENDENT ON THE FINANCIAL RESULTS OF THE ENTIRE ALEGENT HEALTH SYSTEM FOR THE FISCAL YEAR. Supplemental Information Part III SCHEDULE J, PART I, LINE 3: ALEGENT HEALTH GOVERNANCE OF EXECUTIVE COMPENSATION: ACTING AS PRUDENT STEWARDS OF ITS FINANCIAL RESOURCES, THE ALEGENT HEALTH BOARD COMPENSATION COMMITTEE RECOMMENDS AND THE BOARD EXECUTIVE COMMITTEE APPROVES EXECUTIVE COMPENSATION PHILOSOPHY, POLICY AND GUIDELINES. IT DOES SO WITH THE OBJECTIVE OF ATTRACTING AND RETAINING TOP EXECUTIVE TALENT TO ENSURE ALEGENT HEALTH IS ABLE TO FULFILL ITS FAITH-BASED MISSION AND ACHIEVE ITS VISION OF BECOMING WORLD-CLASS. THE ALEGENT HEALTH COMPENSATION COMMITTEE FOLLOWS A THOROUGH AND INTENTIONAL PROCESS THAT INCLUDES CONSULTATION WITH INDEPENDENT, EXPERT COUNSEL AND CAREFULLY COMPARES COMPENSATION LEVELS TO MARKET-BASED COMPENSATION OF SIMILAR SIZED, NON-PROFIT AND FOR-PROFIT HEALTH SYSTEMS AND ALSO UTILIZES A BLEND OF NOT-FOR PROFIT AND GENERAL INDUSTRY DATA FOR EXECUTIVE ROLES WHERE THE RECRUITING MARKET IS ARGUABLY BROADER THEN THE NOT-FOR-PROFIT SECTOR. TOTAL COMPENSATION INCLUDES BASE COMPENSATION, AND ALSO INCLUDES PERFORMANCE-BASED INCENTIVE COMPENSATION FOR ACHIEVING BOARD-SET GOALS FOR CLINICAL QUALITY, PATIENT SAFETY AND SATISFACTION, PHYSICIAN PERCEPTION, STRATEGIC AND FACILITY PLANNING AND FINANCIAL PERFORMANCE. IT MAY ALSO INCLUDE OTHER CASH PAYMENTS SUCH AS ONE-TIME RELOCATION COSTS. SCHEDULE J, PART II: THE ALEGENT HEALTH EXECUTIVES HAVE A PROVISION IN THEIR COMPENSATION AGREEMENT THAT PROVIDES FOR POTENTIAL SEVERANCE PAYMENTS IN THE EVENT OF TERMINATION WITHOUT CAUSE OR CHANGE OF CONTROL. THE AMOUNT OF SEVERANCE AN EXECUTIVE MAY OR MAY NOT RECEIVE IF TERMINATED ACCORDING TO THE COMPENSATION AGREEMENT IS INCLUDED AS DEFERRED COMPENSATION IN COLUMN C. Form 990, Part VI, Section A, line 6 THE SOLE MEMBER OF THE CORPORATION SHALL BE IMMANUEL HEALTH SYSTEMS (IHS). IMMANUEL HEALTH SYSTEMS SHALL NOT HAVE ANY VOTING RIGHTS AS A MEMBER OF THE CORPORATION. Form 990, Part VI, Section A, line 7a THE BUSINESS AND AFFAIRS OF THE CORPORATION SHALL BE MANAGED BY OR UNDER THE DIRECTION OF THE ALEGENT BOARD OF DIRECTORS, AND THE CORPORATION HEREBY DELEGATES TO THE ALEGENT BOARD OF DIRECTORS, TO THE EXTENT PERMITTED BY LAW, COMPLETE GOVERNANCE AUTHORITY OVER IT, SUBJECT ONLY TO THE APPROVAL POWERS OF THE ALEGENT CORPORATE MEMBERS SET FORTH IN THE ARTICLES OF INCORPORATION AND BYLAWS. DIRECTORS SHALL BE APPOINTED BY THE ALEGENT BOARD IMMEDIATELY FOLLOWING THE APPOINTMENT AND RATIFICATION BY ALEGENT CORPORATE MEMBERS OF THE ALEGENT DIRECTORS PURSUANT TO THE ARTICLES OF INCORPORATION AND BYLAWS OF ALEGENT. THE ALEGENT BOARD SHALL APPOINT DIRECTORS SUCH THAT, AT ALL TIMES, ALL OF THE PERSONS SERVING AS ALEGENT DIRECTORS ALSO SHALL BE SERVING AS DIRECTORS OF THE CORPORATION. Form 990, Part VI, Section A, line 7b THE FOLLOWING ACTIONS SHALL BE EFFECTIVE ONLY IF APPROVED BY THE ALEGENT BOARD AND BY BOTH IMMANUEL HEALTH SYSTEMS (IHS) AND CATHOLIC HEALTH INITIATIVES (CHI) IN THEIR CAPACITIES AS ALEGENT CORPORATE MEMBERS: A. ADOPTION OR AMENDMENT OF THE UNIFIED PHILOSOPHY AND MISSION OF THE CORPORATION; B. SALE, LEASE, TRANSFER, ENCUMBRANCE OR DISPOSITION OF THE TANGIBLE PROPERTY OR INVESTMENTS OF THE CORPORATION HAVING A FAIR MARKET VALUE IN ANY INDIVIDUAL TRANSACTION IN EXCESS OF $3 MILLION OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS, PROVIDED THAT TRANSFERS OF INVESTMENTS BETWEEN THE CORPORATION AND ANOTHER PARTICIPANT SHALL NOT REQUIRE THE APPROVAL OF CHI AND IHS; AND PROVIDED FURTHER THAT APPROVAL OF CHI AND IHS SHALL NOT BE REQUIRED FOR ANY TRANSFER OF ASSETS TO CHI BY THE CORPORATION PURSUANT TO THE TERMS OF THE ALEGENT FINANCING AGREEMENT(AFA); C. INCURRENCE, ASSUMPTION OR GUARANTY BY THE CORPORATION IN ANY INDIVIDUAL TRANSACTION OF LONG-TERM INDEBTEDNESS, INCLUDING CAPTIAL LEASES, OUTSTANDING FOR MORE THAN 365 DAYS, IN EXCESS OF THE GREATER OF $2 MILLION OR 2% OF THE TOTAL LONG-TERM INDEBTEDNESS OF ALL THE PARTICIPANTS, OR SUCH GREATER AMOUNT AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS; D. MERGER, DISSOLUTION, CONSOLIDATION OR SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION EXCEPT FOR A MERGER IN WHICH (I) THE CORPORATION IS THE SURVIVING ENTITY, AND (II) THE TOTAL BOOK VALUE OF THE ASSETS OF THE MERGING ENTITY DOES NOT EXCEED 2% OF THE TOTAL BOOK VALUE OF THE ASSETS OF ALL THE PARTICIPANTS, OR SUCH GREATER VALUE AS MAY BE DETERMINED FROM TIME TO TIME BY CHI AND IHS; AND E. NOTWITHSTANDING ANY OTHER PROVISIONS IN THE BYLAWS TO THE CONTRARY. THE ACTIONS THAT CAN BE TAKEN WITHOUT THE APPROVAL OF IHS AND CHI INCLUDE, WITHOUT LIMITATION: (I) TERMINATION OF THE AFA IN ACCORDANCE WITH ITS TERMS. (II) FORMATION OF THE UNIFIED ALEGENT HEALTH SYSTEM (AS THAT TERM IS DEFINED IN THE AFA) (III) PREPAYMENT BY THE CORPORATION OF THE FULL AMOUNTS OUTSTANDING ON ITS NOTES TO CHI UNDER THE AFA, FOR PURPOSES OF EXERCISING THE RIGHTS OF TERMINATION OF THE AFA, OR FORMATION OF THE UNIFIED ALEGENT HELATH SYSTEM CREDIT, AND THE TAKING OF ALL ACTIONS NECESSARY OR APPROPRIATE TO OBTAIN FUNDING OR OTHERWISE MAKE ARRANGEMENTS TO PREPAY SUCH NOTES INCLUDING WITHOUT LIMITATION INCURRENCE OF INDEBTEDNESS NECESSARY OR APPROPRIATE TO PREPAY THE NOTES OUTSTANDING. Form 990, Part VI, Section B, line 11 Tax returns for entities of the Alegent Health system are prepared by THE SYSTEM tax department. Following the preparation of ALEGENT HEALTH-IMMANUEL MEDICAL CENTER Form 990 by internal tax staff, the return is reviewed by the Tax Director, External Tax Advisor and the Chief Financial Officer. The final tax return is posted on the electronic DIRECTOR'S portal to be reviewed and presented at the Finance and Audit Committee of the Board. The Chief Financial Officer and Tax Director are present at the Finance and Audit Committee meeting to answer questions. Additionally, the Board of Directors are notified that the final Form 990, including all required schedules is available on the electronic portal for review and will be filed on May 16, 2011. Form 990, Part VI, Section B, line 12c Written Conflict of Interest Policy - ALEGENT HEALTH-IMMANUEL MEDICAL CENTER has adopted the conflict of interest policy and conflict investigation process of Alegent Health, the parent corporation of the Alegent Health System. Annual completion of the disclosure statement is required By the Board of DIRECTORS. Stated disclosures are investigated by the Alegent Health Compliance Officer and reported to the Conflicts of Interest Committee. The Conflicts of Interest Committee reviews the investigation and makes recommendations to the Governance Committee. The Governance Committee makes the final determination of whether or not there is a disqualifying event and communicates it to the Board OF DIRECTORS. At any time a Board Member or Key Employee may declare a conflict of interest and recuse his/herself from the discussion. The individual is also required to disclose any known or possible conflicts of interest that arise during the calendar year. Form 990, Part VI, Section B, line 15 The governing board engaged the services of an independent consulting firm that holds itself out to the public as a compensation consultant that is qualified to and regularly performs executive and officer compensation studies. The consulting firm conducted a review and analysis of the total compensation paid to the CEO and other officers and key employees of the organization, based on comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated organizations and determined that the compensation was reasonable. The consulting firm issued an opinion letter as to the reasonableness of the total compensation paid to employees identified as disqualified persons. The opinion letter setting forth the findings was reviewed and approved by the compensation committee of the governing board. Contemporaneous documentation and recordkeeping with respect to deliberations and decisions regarding the compensation arrangements were maintained. This process was used for the following positions: PRESIDENT AND CHIEF EXECUTIVE OFFICER EXECUTIVE VICE PRESIDENT SENIOR VICE PRESIDENT AND CHIEF FINANCIAL OFFICER CHIEF EXECUTIVE OFFICER ALEGENT HEALTH CLINIC SENIOR VICE PRESIDENT CHIEF OPERATIONS OFFICER SENIOR VICE PRESIDENT CHIEF MEDICAL OFFICER MEDICAL DIRECTORS (IMMANUEL) VICE PRESIDENT OPERATIONS SENIOR VICE PRESIDENT GENERAL COUNSEL SENIOR VICE PRESIDENT CHIEF INFORMATION OFFICER SENIOR VICE PRESIDENT HUMAN RESOURCES SENIOR VICE PRESIDENT MARKETING Form 990, Part VI, Section C, line 19 The conflict of interest policy is made available to the public on the website at www.alegent.com. ALEGENT HEALTH-IMMANUEL MEDICAL CENTER does not make the financial statements or governing documents available to the public. However, the ARTICLES OF INCORPORATION are available at www.sos.state.ne.us. FORM 990, PART I, LINE 5 AND PART V, LINE 2A: THE EMPLOYEES LISTED IN PART I, LINE 5 AND PART V, LINE 2A ARE EMPLOYED BY ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. HOWEVER, THROUGH A COMMON PAY AGENT AGREEMENT, THE EMPLOYEES ARE PAID BY ALEGENT HEALTH AND PAYROLL EXPENSES ARE ALLOCATED TO ALEGENT HEALTH-IMMANUEL MEDICAL CENTER. FORM 990, PART V, LINE 1A: PAYMENTS TO VENDORS FOR ENTITIES THAT ARE PART OF THE ALEGENT HEALTH SYSTEM ARE MADE BY ALEGENT HEALTH, THEREFORE NO FORM 1099S ARE ISSUED BY ALEGENT HEALTH-IMMANUEL MEDICAL CENER. ALEGENT HEALTH FILES THE FORM 1099S AND COMPLIES WITH THE BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND GAMING WINNINGS. HOWEVER, PER THE INSTRUCTIONS, THOSE 1099S ISSUED BY ALEGENT HEALTH ON BEHALF OF ALEGENT HEALTH-IMMANUEL MEDICAL CENTER ARE REPORTED. FORM 990, PART VI, SECTION B, LINE 16: ALEGENT HEALTH-IMMANUEL MEDICAL CENTER HAS NOT FORMALLY ADOPTED A WRITTEN POLICY OR WRITTEN PROCEDURE REGARDING JOINT VENTURES. HOWEVER, ALEGENT HEALTH'S SYSTEM-WIDE JOINT VENTURE MODEL INCORPORATES CONTROLS OVER THE VENTURE SUFFICIENT TO ENSURE THAT (1) THE EXEMPT ORGANIZATION AT ALL TIMES RETAINS CONTROL OVER THE VENTURE SUFFICIENT TO ENSURE THAT THE PARTNERSHIP FURTHERS THE EXEMPT PURPOSE OF THE ORGANIZATION; (2) IN ANY PARTNERSHIP IN WHICH THE EXEMPT ORGANIZATION IS A PARTNER, ACHIEVEMENT OF EXEMPT PURPOSES IS PRIORITIZED OVER MAXIMIZATION OF PROFITS FOR THE PARTNERS; (3) THE PARTNERSHIP DOES NOT ENGAGE IN ANY ACTIVITIES THAT WOULD JEOPARDIZE THE EXEMPT ORGANIZATION'S EXEMPTION; (4) RETURNS OF CAPITAL, ALLOCATIONS AND DISTRIBUTIONS MUST BE MADE IN PROPORTION TO THE PARTNER'S RESPECTIVE OWNERSHIP INTERESTS; AND (5) ALL CONTRACTS ENTERED INTO BY THE PARTNERSHIP WITH THE EXEMPT ORGANIZATION MUST BE AT ARM'S LENGTH, WITH PRICES SET AT FAIR MARKET VALUE. 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